Supplementation With Dexmedetomidine for Transsphenoidal Resection of Pituitary Adenoma: A Meta-Analysis of Randomized Controlled Trials

Abstract

The effect of dexmedetomidine supplementation on hemodynamic stability for transsphenoidal resection of pituitary adenoma remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexmedetomidine supplementation on hemodynamic stability for transsphenoidal resection of pituitary adenoma. We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2020 for randomized controlled trials assessing the effect of dexmedetomidine supplementation on transsphenoidal resection of pituitary adenoma. Four randomized controlled trials involving 160 patients were included in the meta-analysis. Overall, compared with the control group for transsphenoidal resection of pituitary adenoma, dexmedetomidine supplementation resulted in significantly reduced mean arterial pressure at 30 minutes [mean difference (MD), -26.62; 95% confidence interval (CI), -36.71 to -16.53; P < 0.00001], heart rate at 30 minutes (MD, -16.50; 95% CI, -32.48 to -0.53; P = 0.04), blood loss (MD, -112.57; 95% CI, -165.12 to -60.01; P < 0.0001), and fentanyl (MD, -154.13; 95% CI, -303.97 to -4.29; P = 0.04), but demonstrated similar incidence of nausea and vomiting (odds ratio, 0.37; 95% CI, 0.13-1.03; P = 0.06), and hypotension (odds ratio, 2.11; 95% CI, 0.49-9.22; P = 0.32). Dexmedetomidine supplementation was effective in improving hemodynamic stability for transsphenoidal resection of pituitary adenoma.